Standard&Poor's Ratings Services affirmed its 'BBB' rating on Northern Hospital District Of Surry County (NHDSC), N.C.'s revenue debt. The outlook is stable. We assessed NHDSC's enterprise profile as adequate characterized by a satisfactory medical staff and sound management, although we assess the rural service area as having very weak economic fundamentals with a very limited population base; and its financial profile as strong with adequate financial performance and solid liquidity and financial flexibility; offset by a limited revenue base, with annualized net patient revenue of $77 million as of the unaudited 12-month period ended Sept. 30, 2015, which is classified as a small hospital under Standard&Poor's criteria. Combined, we think these credit factors lead to an